NT-Pro BNP、CRP及D-Dimer在COPD急性加重期合并肺动脉高压中的相关性研究
NT-Pro BNP、CRP급D-Dimer재COPD급성가중기합병폐동맥고압중적상관성연구
Correlation study of serum NT-Pro BNP, CRP and D-Dimer levels in patients of AECOPD with pulmonary hypertension
  • 万方数据
    国际呼吸杂志 국제호흡잡지
    INTERNATIONAL JOURNAL OF RESPIRATION
    2014年 5期 341-346 ,共6页

    赵燕霞%黄相增

    조연하%황상증

    慢性阻塞性肺疾病%肺动脉高压%氨基末端脑钠肽前体%C反应蛋白%D-二聚体 慢性阻塞性肺疾病%肺動脈高壓%氨基末耑腦鈉肽前體%C反應蛋白%D-二聚體
    만성조새성폐질병%폐동맥고압%안기말단뇌납태전체%C반응단백%D-이취체
    Chronic obstructive pulmonary disease%Pulmonary hypertension%N-terminal pro-brain natriuretic peptide%C-reaction protein%D-Dimer
    目的 探讨血清氨基末端脑钠肽前体(amino-terminal pro-brain natriuretic peptide,NT-Pro BNP)、C反应蛋白(C reaction protein,CRP)及D-二聚体(D-Dimer)水平在慢性阻塞性肺疾病急性加重期(AECOPD)合并肺动脉高压(PH)患者中的临床意义及相关性.方法 入选126例AECOPD患者,超声心动图测得肺动脉收缩压(PASP)值,根据PASP分为3组:对照组(＜40 mmHg) 45例、轻度PH组(40～～60 mmHg)47例和中重度PH组(＞60 mmHg) 34例.对所有入选患者进行血清NT-ProBNP、CRP 、D-Dimer水平和动脉血气分析检测.结果 AECOPD合并中重度PH组患者NT-Pro BNP[(1 711.15±437.05) ng/L]、PCO2[(47.24±8.60) mmHg]、CRP[(25.53±1.73) mg/L]及D-Dimer[(648.88±618.87) μg/L]水平高于对照组[NT-Pro BNP:(221.78±63.62) ng/l;PCO2:(40.04±6.83) mmHg;CRP:(11.51±2.00) mg/L;D-Dimer:(302.58±233.44) μg/L],差异均具有统计学意义(t=4.005,3.880,-3.094,-4.073;P值均＜0.05);而PO2[(59.43±16.49) mmHg]低于对照组[(71.28±15.16) mmHg,差异具有统计学意义(t=3.276; P＜0.05). AECOPD合并中重度PH组患者NT-Pro BNP[(1 711.15±437.05) ng/L]和PCO2[(47.24±8.60) mmHg]水平高于轻度PH组[(NT-Pro BNP:(583.77±213.98) ng/L;PCO2:(40.85±8.96) mmHg],差异均具有统计学意义(t=-3.069,-3.442;P值均＜0.05);而PO2[(59.43±16.49) mmHg]低于轻度PH组[(66.81±16.22) mmHg],差异具有统计学意义(t=2.061;P＜0.05). AECOPD合并轻度PH组患者CRP[(17.55±4.17) mg/L]及D-Dimer[(501.61±218.71) μg/L]水平高于对照组[CRP:(11.51±2.00) mg/L;D-Dimer:(302.58±233.44) μg/L],差异均具有统计学意义(t=1.452,2.551;P值均-＜0.05).NT-Pro BNP与PASP、PCO2均呈正相关(r=0.346,t =4.11; r=0.336,t=3.97;P值均＜0.05).PCO2 、CRP、D-Dimer与PASP均呈正相关(r=0.389,t =4.70; r=0.245,t=2.81;r=0.349,t=4.15;P值均＜0.05);PO2与PASP呈负相关(r=-0.262,t=-3.02,P＜0.05).结论 血清NT-Pro BNP、CRP及D-Dimer水平与PASP密切相关,可以作为AECOPD患者判断PH严重程度的指标.
    목적 탐토혈청안기말단뇌납태전체(amino-terminal pro-brain natriuretic peptide,NT-Pro BNP)、C반응단백(C reaction protein,CRP)급D-이취체(D-Dimer)수평재만성조새성폐질병급성가중기(AECOPD)합병폐동맥고압(PH)환자중적림상의의급상관성.방법 입선126례AECOPD환자,초성심동도측득폐동맥수축압(PASP)치,근거PASP분위3조:대조조(＜40 mmHg) 45례、경도PH조(40～～60 mmHg)47례화중중도PH조(＞60 mmHg) 34례.대소유입선환자진행혈청NT-ProBNP、CRP 、D-Dimer수평화동맥혈기분석검측.결과 AECOPD합병중중도PH조환자NT-Pro BNP[(1 711.15±437.05) ng/L]、PCO2[(47.24±8.60) mmHg]、CRP[(25.53±1.73) mg/L]급D-Dimer[(648.88±618.87) μg/L]수평고우대조조[NT-Pro BNP:(221.78±63.62) ng/l;PCO2:(40.04±6.83) mmHg;CRP:(11.51±2.00) mg/L;D-Dimer:(302.58±233.44) μg/L],차이균구유통계학의의(t=4.005,3.880,-3.094,-4.073;P치균＜0.05);이PO2[(59.43±16.49) mmHg]저우대조조[(71.28±15.16) mmHg,차이구유통계학의의(t=3.276; P＜0.05). AECOPD합병중중도PH조환자NT-Pro BNP[(1 711.15±437.05) ng/L]화PCO2[(47.24±8.60) mmHg]수평고우경도PH조[(NT-Pro BNP:(583.77±213.98) ng/L;PCO2:(40.85±8.96) mmHg],차이균구유통계학의의(t=-3.069,-3.442;P치균＜0.05);이PO2[(59.43±16.49) mmHg]저우경도PH조[(66.81±16.22) mmHg],차이구유통계학의의(t=2.061;P＜0.05). AECOPD합병경도PH조환자CRP[(17.55±4.17) mg/L]급D-Dimer[(501.61±218.71) μg/L]수평고우대조조[CRP:(11.51±2.00) mg/L;D-Dimer:(302.58±233.44) μg/L],차이균구유통계학의의(t=1.452,2.551;P치균-＜0.05).NT-Pro BNP여PASP、PCO2균정정상관(r=0.346,t =4.11; r=0.336,t=3.97;P치균＜0.05).PCO2 、CRP、D-Dimer여PASP균정정상관(r=0.389,t =4.70; r=0.245,t=2.81;r=0.349,t=4.15;P치균＜0.05);PO2여PASP정부상관(r=-0.262,t=-3.02,P＜0.05).결론 혈청NT-Pro BNP、CRP급D-Dimer수평여PASP밀절상관,가이작위AECOPD환자판단PH엄중정도적지표.
    Objective To explore the clinical significance and correlation of serum amino terminal pro brain natriuretic peptide (NT Pro BNP),C-reaction protein (CRP) and the D-Dimer levels in patients of the acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with pulmonary hypertension(PH).Methods One hundred and twenty six patients with AECOPD were measured pulmonary artery systolic pressure (PASP) by echocardiography.They were divided into 3 groups according to PASP:control group (＜40 mmHg) 45 cases,mild PH group (40～60 mmHg) 47 cases and mederate-severe PH group (＞60 mmHg) 34 cases.Serum NT Pro BNP,CRP,D-Dimer levels and arterial blood gas analysis were detected from all the selected patients.Results Serum NT Pro BNP,PCO2,CRP and D-Dimer in AECOPD with mederate-severe PH group [NT-Pro BNP:(1 711.15 ± 437.05) ng/L;PCO2:(47.24±8.60) mmHg;CRP:(25.53±1.73) mg/L;D-Dimer:(648.88±618.37) μg/L]were significantly higher than the control ones [NT-Pro BNP:(221.78±63.62) ng/L;PCO2:(40.04±6.83) mmHg;CRP:(11.51±2.00) mg/L;D-Dimer:(302.58±233.44) μg/L](t =-4.005,-3.880,-3.094,-4.073; P ＜0.05) ;while PO2 [arterial partial pressure of oxygen:(59.43 ± 16.49) mmHg]were significantly lower than the control ones (71.28±15.16) mmHg (t =3.276; P ＜0.05).Serum NT-Pro BNP,PCO2 in AECOPD with mederate-severe PH group [NTPro BNP:(1 711.15 ±437.05) ng/L; PCO2:(47.24 ± 8.60) mmHg] ; were significantly higher than the mild PH ones [NT Pro BNP:(583.77±213.98) ng/L;PCO2:(40.85±8.96) mmHg](t =-3.069,-3.442; P ＜0.05) ;while PO2 (59.43 ± 16.49)] mmHg were significantly lower than the mild PH group ones (66.81 ±16.22) mmHg (t =2.061; P ＜0.05).Serum CRP and the D-Dimer levels in mild PH group [CRP:(17.55 ±4.17) mg/L;D-Dimer:(501.61±218.71) μg/L] were significantly higher than the control ones [CRP:(11.51±2.00) mg/L;D-Dimer:(302.58±233.44) μg/L](t =-1.452,-2.551; P ＜ 0.05).NT-Pro BNP was observered a significant positive linear relationship between PASP (r =0.346,t =4.11,P ＜0.01) and PCO2(r =0.336,t =3.97,P ＜0.01)).We also found that PCO2,CRP,D-Dimer levels have a significant positive linear relationship between PASP(r =0.389,t =4.70; r 0.245,t =2.81; r =0.349,t=4.15; P＜0.05),whilePO2 was negatively correlated withPASP (r=-0.262,t=3.02,P ＜ 0.05).Conclusions Serum NT-Pro BNP,CRP and D-Dimer levels are closely related to the PASP,and can be used as indicators to judge the severity of PH in of AECOPD patients.
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